POSTDOCTORAL TRAINING IN ALTERNATIVE MEDICINE NIH GUIDE, Volume 23, Number 1, January 7, 1994 PA NUMBER: PA-94-025 P.T. 44 Keywords: Biomedical Research Training Biomedical Research, Multidiscipl Office of Alternative Medicine National Institutes of Health Application Receipt Dates: April 5, August 5, and December 5 PURPOSE The Office of Alternative Medicine (OAM) is planning to fund, through the various Institutes at the National Institutes of Health (NIH), individual postdoctoral training awards for FY 94 using the National Research Service Award (NRSA) mechanism. The purpose is to provide a cadre of investigators capable of conducting systematic studies on safety, efficacy, cost-effectiveness, or mechanisms of action of unconventional methods for treating major diseases and promoting well-being. This training is expected to attract postdoctoral candidates who are in the early stages of their careers. They will have obtained expertise in conventional research methodology and some familiarity with/or interest in alternative medical procedures. Prospective trainees will be expected to form an alliance with established researchers to provide a mutual learning experience. This program announcement (PA) on Alternative Medicine is an abbreviation of a larger, NIH-wide PA on NRSA Individual Postdoctoral Fellows, which should be requested from the contact person listed below. ELIGIBILITY REQUIREMENTS Individuals must be citizens or noncitizen nationals of the United States, or have been lawfully admitted to the U.S. for permanent residence (i.e., in possession of a currently valid Alien Registration Receipt Card 1-551 or in possession of other legal verification of such status.) Prior to beginning the award the applicant must have received a Ph.D., M.D., D.O., D.D.S., D.V.M., 0.D., D.P.M., Sc.D., Eng.D, Dr. P.H., D.N.S., D.Pharm., D.S.W., or Psy. or equivalent doctoral degree from an accredited domestic or foreign institution. Before submitting a fellowship application, the applicant must arrange for appointment to an appropriate, accredited university, hospital, or other institution with facilities including staff for postdoctoral training. This may include institutions that train in areas outside conventional medicine such as acupuncture or chiropractic. The candidate should be accepted by a sponsor who will actively supervise the training. The sponsor should have research experience in clinical medicine and/or basic pre-clinical research along with an involvement in the evaluation of alternative medicine. Thus, the sponsor should be qualified to supervise in the application of rigorous study design to the assessment of individual alternative therapies. Because of the novelty of some procedures, it is recognized that the sponsor may not have reached the level of "senior" investigator in a particular field of alternative medicine. Applicants proposing training at their doctorate institution or at the institution where they have been training for more than a year must document thoroughly the opportunity for new training experiences that would increase their scientific background relating to Alternative Medicine. MECHANISM OF SUPPORT The mechanism of support is the Individual National Research Service Award. Individuals may request up to 3 years of aggregate NRSA support at the postdoctoral level. The stipend level for the first year of NRSA support is determined by the number of years of relevant postdoctoral experience at the time the award is issued. The range of support is from $18,600 (less than l full year of experience) to $32,300 (7 or more years of experience). Relevant experience includes research experience, teaching, internship, residency, and clinical duties. Supplementation, when provided, must not require obligation from the fellow. Under no circumstances may PHS grant funds be used for supplementation. NIH will provide an institutional allowance of $3,000 per 12-month period to non-Federal nonprofit sponsoring institutions to help defray such awardee expenses as tuition and fees, self-only health insurance, research supplies, equipment, travel to scientific meetings, and related items. For individuals sponsored by Federal laboratories, or for-profit institutions, the NIH will provide up to $2,000 for scientific meeting travel expenses, self-only health insurance, tuition fees, and books. Fellows in the first twelve months of postdoctoral NRSA support will incur a service obligation of one month for each month of support. Additional information is contained in the NIH Guide, Vol 22, July 30, 1993. It is expected that four to six awards in Alternative Medicine will be made in FY 1994. RESEARCH OBJECTIVES The OAM was established in 1992 to evaluate and determine the efficacy of various unconventional, alternative or complementary medical practices. A recent survey demonstrated that as many as 34 percent of adults utilized at least one alternative, therapy for the treatment of a serious or bothersome medical condition during the previous year (Eisenberg, D. et al, New England J. Med. 328: 246-252, 1993). The cost for services provided by alternative practitioners is estimated to be more than $13 billion a year. Many of these interventions have not, however, been subjected to scientific scrutiny using conventional research methods. Existing research in this area is limited by a paucity of well designed trials, and there are few research data bases which allow for systematic review or meta-analysis of treatment efficacy. OAM feels that it is important to better understand if any of these therapies benefit the patients that use them. Unconventional practices include medical interventions that are not widely taught at medical schools or are not generally available at hospitals within the United States. For the most part, such treatments are not reimbursable by third party (insurance companies) payers. Examples of areas of interest include, but are not limited to: acupuncture; homeopathy; structural manipulation including chiropractic/massage; visual imagery, relaxation techniques, meditation, herbal therapies, or diet and life style. The Office is especially interested in alternative procedures in the treatment of life threatening diseases, e.g., women's breast cancer or AIDS-HIV and the subsequent impact on either/and: a) course of disease; b) wellness/quality of life/ prevention; c) statistical/population disease trends d) basic biological systems. However, any particular health problem such as arthritis, depression, drug or alcohol addiction, or heart disease is acceptable. APPLICATION PROCEDURES Applicants should submit a completed Application for Public Health Service Individual National Research Service Award (PHS 416-1 rev. 10/91), including with the application at least three letters of reference. Application kits can be obtained from the following address: Grants Information Office Division of Research Grants National Institutes of Health Westwood Building, Room 449 Bethesda, MD 20892 Phone: (301) 710-0267 Applicants and sponsoring institutions must comply with policies and procedures governing the protection of human subjects, the humane care and use of live vertebrate animals, and the inclusion of women and minorities in study populations. REVIEW CONSIDERATIONS The review criteria will focus on the following main components: a) the applicant's academic preparation; b) the scientific merit of the proposed research including the clarification of treatment efficacy of a particular alternative medical procedure; c) training potential for the student; d) the training resources and environment, including the sponsor. Following the initial review, the grant application will be assigned to one of the institutes based on the major health problem to be evaluated; e.g., alternative procedures evaluating cancer would be assigned to the National Cancer Institute (NCI). A second level of review will be provided by a committee or staff from the relevant institute and the OAM. AWARD CRITERIA The following criteria will be used by the NIH in making awards: a) individual review group (IRG) recommendation of the overall merit of the application; b) relevance of the application to the research priorities of the Institute and the OAM along with program balance; c) availability of funds. INQUIRIES Written and telephone inquiries concerning this PA are encouraged. The opportunity to clarify any issue or question(s) from potential applicants is welcome. Direct inquiries regarding programmatic issues to: Dr. John Spencer Office of Alternative Medicine National Institutes of Health 6120 Executive Boulevard, Suite 450 Rockville, MD 20892-9904 Telephone: (301) 402-4333 FAX: (301) 402-4741 AUTHORITY AND REGULATIONS NRSAs are made under the authority of Section 487 of the Public Health Service Act as amended (42 USC 288) and Title 42 of the Code of Federal Regulations, Part 66. .
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